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目的探讨液基细胞学检查结果为意义不明确的非典型鳞状细胞(ASCUS)的临床意义及处理方法。方法对2008年5月至2010年11月在妇科门诊的218例宫颈液基细胞学检查(TCT)诊断为ASCUS患者的临床资料在阴道镜下进行宫颈组织多点活检,其中100例同时进行了HPV分型检测。结果 218例宫颈薄层液基细胞学ASCUS诊断中,组织病理学结果为炎症90例(41.02%),宫颈上皮内瘤样病变(CIN)Ⅰ级64例(29.39%),CINⅡ/Ⅲ级51例(23.27%),宫颈癌14例(6.33%);高危型HPV(HR-HPV)阳性组CINⅡ级以上病变检出率为42.72%(88/206),明显高于HR-HPV阴性组22.95%(14/61),差异有统计学意义(χ2=7.79,P=0.005)。结论细胞学报告为ASCUS时,组织病理学检查结果从炎症到宫颈癌均有分布,对其临床处理应引起重视。HR—HPV检测对ASC—US的临床处理具有科学分流管理的意义。
Objective To investigate the clinical significance and treatment of atypical squamous cells (ASCUS) whose liquid-based cytology results are not clear. Methods The clinical data of 218 cervical cytology-based cytology (TCT) diagnosed as ASCUS in gynecology outpatients from May 2008 to November 2010 were examined by colposcopy with multi-biopsy of cervical tissue, of which 100 cases were performed simultaneously HPV typing test. Results The histopathology results of 218 cervical smear-based cytology ASCUS were 90 (41.02%), 64 (29.39%) with CIN, 51 (23.27%) and cervical cancer (14.3%). The positive rate of CINⅡlevel in high-risk HPV positive group was 42.72% (88/206), which was significantly higher than that of HR-HPV negative group % (14/61), the difference was statistically significant (χ2 = 7.79, P = 0.005). Conclusion Cytology report ASCUS, histopathological examination results from inflammation to cervical cancer are distributed, its clinical treatment should pay attention. HR-HPV testing has clinical implications for the clinical management of ASC-US.